Dysfunctional Breathing

Sleep Apnea for Kids and Adults
Avoiding Mouth Breathing
Heart Rate Variability

Dr Roca started in July 2021 an intense integrative breathing class that lasts 6 months. She signed up for this class that meets weekly to learn exactly what dysfunctional breathing is, how to recognize it and how to correct it. She has found that teaching just one breathing method is not enough for all. Many medical conditions and patients require a specific breathing method for their symptoms. This class has been eye opening and Dr Roca is thrilled to be able to teach her patients how to correct their dysfunctional breathing that is 100 percent connected to our health and our sleep.

Defining Dysfunctional Breathing

The term ‘dysfunctional breathing’ (DB) started to be used as growing uncertainty of the link between hypocapnia and symptoms of the hyperventilation syndrome made the use of that term controversial [29, 41].
Initially the term dysfunctional breathing seemed to be used almost as a proxy for hyperventilation syndrome but it has now evolved to be umbrella term for any functional breathing disorder including hyperventilation, breathing pattern disorders, paradoxical vocal fold motion, inducible laryngeal obstruction, psychological breathing disorders and some inappropriate breathing behaviors such as chronic mouth breathing.
Despite vagueness of definition the term dysfunctional breathing was commonly used. The following table shows around 45 studies that mentioned dysfunctional breathing in the title between 2001 to 2020. Earliest reference was by Piani in 1961“Dysfunctional Respiratory Syndrome”.

Table 1- Literature Review-Term Dysfunctional Breathing

Dysfunctional breathing does not have a formal agreed definition or gold standard diagnostic method.

Dysfunctional Breathing, Breathing Patterns and The Biomechanical Dimension

Some recent definitions of dysfunctional breathing have put emphasis on breathing patterns and link symptoms to the biomechanical neuromuscular aspects of breathing.

Examples in the recent literature:
“Dysfunctional breathing is a term describing a group of breathing disorders in patients where chronic changes in breathing pattern result in dyspnoea and often non respiratory symptoms in the absence of, or in excess of, organic respiratory disease”[60].

“Dysfunctional breathing (DB) is an overarching term describing deviations in the normal biomechanical patterns of breathing which have a significant impact on quality of life, performance and functioning. DB can be viewed as having two components; breathing pattern disorder (BPD) and inducible laryngeal obstruction (ILO)”[43].

“Dysfunctional Breathing can be defined as an alteration in the normal biomechanical patterns of breathing that result in intermittent or chronic symptoms. It can be subdivided into thoracic and extra thoracic forms. Thoracic DB is characterized by breathing patterns involving relatively inefficient, excessive upper chest wall activity with or without accessory muscle activity. This is frequently associated with increased residual volume, frequent sighing and an irregular pattern of respiratory effort. It may be accompanied by true hyperventilation in the minority of subjects. Extra thoracic forms include paradoxical vocal cord dysfunction and the increasingly recognised supra-glottic ‘laryngomalacia’ commonly seen in young sportsmen and women”[89].

Breathing Pattern Disorders

The term breathing pattern disorders first started appearing in the literature in papers discussing the impact of habitual breathing on muscular-skeletal pain, posture and movement patterns [90, 91]. Recently the term breathing pattern disorder has started to be used interchangeably with dysfunctional breathing [42, 92].

Definition of a breathing pattern disorder
A breathing pattern disorder is a form of dysfunctional breathing that occurs when the normal relaxed respiratory cycle is replaced either intermittently or habitually with abnormal breathing patterns . Attempts have been made to classify different types of abnormal breathing pattern in adult patients with five different patterns being identified; hyperventilation syndrome, periodic deep sighing, thoracic dominant breathing, forced abdominal expiration and thoraco-abdominal asynchrony. [43]

Table 2- Articles using terms Breathing Pattern Disorders

Breathing Basics #1 sequence

© Dr. Rosalba Courtney 2021